Variability in caries detection and treatment plans for occlusal surfaces among undergraduate senior dental students

The changes observed in the pattern of dental caries development have created major difficulties for professionals to detect the presence and extent of the carious lesion precisely, as well as doubts with regard to decisions about treatment. In spite of the importance of this issue, little is known about this problem in the training process of dentistry course students. Therefore, the object of this study was to assess the inter-examiner agreement about carious lesion detection and the treatment decision about occlusal caries, among undergraduate seniors of the dentistry course. Twenty posterior permanent teeth without apparent cavitations were mounted in a dentistry mannequin and radiographed using the bitewing technique. Sixtyone students (76.3%) in the last year of a dentistry course at a public university in the interior of the state of Sao Paulo = assessed the surfaces by means of clinicalradiographic examination, performed caries detection and suggested a = treatment plan for each surface. Inter-examiner agreement was obtained by means of Kappa statistics. It was observed that the kappa statistic values – inter-examiner agreement  for caries detection (к=0.4), the determining of its activity (к=0.50), and the clinical decision making (к=0.52) were considered moderate for the criteria assessed. The most recommended non-invasive treatment was resinous sealing (35.31%), whereas restorations with light polymerizable resin were the most recommended invasive strategy (71.1%); nevertheless, there were marked differences with regard to the decision taken regarding which strategy to use. The results of this study evidenced the need for implementing teaching/learning strategies based on training/constant calibration of academic students to minimize these variations, contributing to a professional education guided by the philosophy of health promotion. The data collection instrument in this study proved efficient and easy to use for assessing this problem among undergraduates.